Individual provider Active NPI

Alex J Schoen, OD

  • Optometrist
  • Marinette, WI
National Provider Identifier
1780336057
Registry record updated Oct 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3753-35 Issued in WI
Practice address
1507 Main St
Marinette, WI 54143-1301
Phone
(715) 735-9593
NPI assigned
Jan 19, 2022
Last updated
Oct 19, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901005601 MI
Optometrist 152W00000X 3753-35 WI Primary

Addresses

Primary practice location

1507 Main St
Marinette, WI 54143-1301

Mailing address

1507 Main St
Marinette, WI 54143-1301
Phone (715) 735-9593

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230120002006 WI Practitioner - Optometry 6305217852 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
William E Bourgeois OD SCGroup PAC ID 0547392326, 2 clinicians

Practice addresses (Care Compare)

1507 Main St
Marinette, WI 54143-1301
Phone (715) 735-9593

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery44

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4901005601MIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
William E, Bourgeois O.D,, S.C. Optometrist CurrentSince Dec 12, 2022 Accepting new patients

Locations

1507 Main St
Marinette, WI 54143
Phone (715) 735-9593

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1642550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666137600000",
    "number": "1780336057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1507 MAIN ST",
            "city": "MARINETTE",
            "state": "WI",
            "postal_code": "541431301",
            "telephone_number": "715-735-9593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1507 MAIN ST",
            "city": "MARINETTE",
            "state": "WI",
            "postal_code": "541431301",
            "telephone_number": "715-735-9593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHOEN",
        "first_name": "ALEX",
        "middle_name": "J",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-01-19",
        "last_updated": "2022-10-19",
        "certification_date": "2022-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901005601",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "3753-35",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marinette, WI

Sources for this page

Verify at the official NPI Registry.